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Clavulanate Disease Interactions

There are 2 disease interactions with clavulanate:

Major

Amoxicillin-clavulanate (Includes clavulanate) ↔ hepatotoxicity

Severe Potential Hazard, Moderate plausibility. Applies to: Liver Disease

The administration of amoxicillin-clavulanate has infrequently been associated with hepatotoxicity such as elevations in serum transaminases, bilirubin, and/or alkaline phosphatase. The histologic findings on liver biopsy have consisted of predominantly cholestatic and/or hepatocellular changes. Symptoms may occur during or several weeks after therapy. The hepatotoxicity is generally reversible, although deaths have been reported on rare occasions, mostly in patients with serious underlying diseases or concomitant use of other medications. Liver enzyme abnormalities have also been observed with the use of amoxicillin or ampicillin alone. According to the manufacturer, therapy with amoxicillin-clavulanate should be administered cautiously in patients with evidence of hepatic dysfunction. Periodic monitoring of liver function is recommended during prolonged therapy. The use of amoxicillin-clavulanate is contraindicated in patients with a history of cholestatic jaundice or hepatic dysfunction associated with the drug.

References

  1. Ryley NG, Fleming KA, Chapman RWG "Focal destructive cholangiopathy associated with amoxycillin/clavulanic acid (augmentin)." J Hepatol 23 (1995): 278-82
  2. Verhamme M, Ramboer C, Van De Bruaene P, Inderadjaja N "Cholestatic hepatitis due to an amoxycillin/clavulanic acid preparation." J Hepatol 9 (1989): 260-4
  3. Silvain C, Fort E, Levillain P, Labat-Labourdette J, Beauchant M "Granulomatous hepatitis due to combination of amoxacillin and clavulanic acid." Dig Dis Sci 37 (1992): 150-2
  4. Hebbard GS, Smith KG, Gibson PR, Bhathal PS "Augmentin-induced jaundice with a fatal outcome." Med J Aust 156 (1992): 285-6
  5. Larrey D, Vial T, Micaleff A, et al. "Hepatitis associated with amoxycillin-clavulanic acid combination report of 15 cases." Gut 33 (1992): 368-71
  6. Habior A, Walewskazielecka B, Butruk E "Hepatocellular-cholestatic liver injury due to amoxycillin-clavulanic acid combination." Clin Investig 72 (1994): 616-8
  7. Garcia Rodriguez LA, Stricker BH, Zimmerman HJ "Risk of acute liver injury associated with the combination of amoxicillin and clavulanic acid" Arch Intern Med 156 (1996): 1327-32
  8. "Product Information. Augmentin (amoxicillin-clavulanate)." SmithKline Beecham, Philadelphia, PA.
  9. Wong FS, Ryan J, Dabkowski P, Dudley FJ, Sewell RB, Smallwood RA "Augmentin-induced jaundice." Med J Aust 154 (1991): 698-701
  10. Dowsett JF, Gillow T, Heagerty A, Radcliffe M, Toadi R, Isle I, Russell RC "Amoxycillin/clavulanic acid (augmentin)-induced intrahepatic cholestasis." Dig Dis Sci 34 (1989): 1290-3
  11. Thomson JA, Fairley CK, Ugoni AM, Forbes AB, Purcell PM, Desmond PV, Smallwood RA, Mcneil JJ "Risk factors for the development of amoxycillin-clavulanic acid associated jaundice." Med J Aust 162 (1995): 638-40
  12. Limauro DL, ChanTompkins NH, Carter RW, Brodmerkel GJ, Agrawal RM "Amoxicillin/clavulanate-associated hepatic failure with progression to Stevens-Johnson syndrome." Ann Pharmacother 33 (1999): 560-4
  13. Friess G, Wienbeck M "Cholestatic jaundice after taking amoxicillin and clavulanic acid." Dtsch Med Wochenschr 120 (1995): 1356-60
View all 13 references
Moderate

Amoxicillin-clavulanate (Includes clavulanate) ↔ PKU

Moderate Potential Hazard, Moderate plausibility. Applies to: Phenylketonuria

Some amoxicillin chewable tablets and suspensions products contain phenylalanine. The phenylalanine content should be considered when these products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).

References

  1. "Product Information. Augmentin (amoxicillin-clavulanate)." SmithKline Beecham, Philadelphia, PA.

Clavulanate drug interactions

There are 26 drug interactions with clavulanate

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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